As hard as I find it to believe, the fifth anniversary of this blog is fast approaching. When I started this whole endeavor, it was more or less on a whim that struck me on a cold, dreary, gray Saturday in December, and I had no idea that five years later I’d still be at it, much less that I’d have this many readers. One thing that trying to apply a skeptical and scientific world view to various pseudoscience has allowed me to do, more than just the occasional fit of depression at looking at pseudoscience now, comparing it to pseudoscience then and back in my Usenet days in the late 1990s and early 2000s, and realizing that teh well of stupid is deep and unyielding indeed, is to see patterns that I didn’t see before, at least not easily. I don’t claim in any way that I’m making what are necessarily original observations; many skeptics have made them before. But there’s a difference between being told these observations and actually seeing them for yourself.
Another thing I’ve been examining over the last five years, ever since I first discovered it, is a relatively few patterns, which is why I almost feel ashamed that I can’t recall ever having explicitly about what Trine Tsouderos and Patricia Callahan at the Chicago Tribune have written as a followup to their excellent expose on the autism “biomed” (i.e., anti-vaccine quackery) movement. I’m sure I’ve alluded to it before, but I don’t think I put it in quite the same terms in one place. Specifically, it’s about how the autism biomed movement abuses existing legitimate scientific studies to justify its quackery. As Tsouderos and Callahan put it, it’s Autism treatment: Science hijacked to support alternative therapies.
That’s exactly what it is.
The story starts out giving a particularly egregious example:
Dr. Carlos Pardo was trying to head off trouble.
The Johns Hopkins neurologist and his colleagues had autopsied the brains of people with autism who died in accidents and found evidence of neuroinflammation. This rare look inside the autistic brain had the potential to increase understanding of the mysterious disorder.
It also, he knew, could inspire doctors aiming to help children recover from autism to develop new experimental treatments — even though the research was so preliminary the scientists did not know whether the inflammation was good or bad, or even how it might relate to autism.
So when Pardo and his colleagues published their paper in the Annals of Neurology in 2005, they added an online primer that clearly explained their findings in layman’s terms and sternly warned doctors not to use them to develop treatments.
“We were concerned that the study would raise a lot of controversy and be misused,” Pardo said. “We were right.”
Over and over, doctors in the autism recovery movement have used the paper to justify experimental treatments aimed at reducing neuroinflammation.
This is not at all a suprise to those of us who have been following the autism quackery movement over the last few years. If there’s a group that’s better at taking legitimate scientific studies and extrapolating from them far beyond what reason, science, medicine, or ethics would ever allow or even what the scientists doing the research could imagine in their worst nightmares, it’s the autism anti-vaccine quackery movement. Indeed, whole organizations, including Generation Rescue and the Autism Research Institute appear to devote huge amounts of effort to cherry picking legitimate scientific studies and using them to justify unproven treatments, many of which are in my estimation (and that of many other physicians and scientists) rank quackery.
I think part of the explanation comes from an extreme disconnect between what real clinician-scientists view as a scientific basis:
Physicians and others in the movement — many affiliated with the organization Defeat Autism Now! — say their treatment protocols rest on a foundation of solid science
And, yes, we frequently hear this from supporters of autism “biomed,” that they’re really scientists, maaaaan! Science. They keep using that word. I do not think it means what they think it means. (Sorry about that, but I couldn’t resist.) Basically, what these DAN! doctors do is to fixate on a single interesting observation that may or may not be widely accepted in the scientific community yet and then devise what they perceive to be interventions based on these observations. That “neuroinflammation” has something to do with autism is perhaps the most prevalent such observation, and many are the woo-ful interventions, including intravenous immunoglobulin, hyperbaric oxygen, and a drug designed to treat a rare genetic disease. There’s no good evidence that any of them work.
The most blatant example of hijacking legitimate science to justify quackery comes from the father-son team of autism “researchers” who operate out of the basement of the father’s Silver Spring, MD home. I’m referring, of course, to Mark and David Geier, the originators of the “Lupron protocol,” which I first wrote about over three years ago and Tsouderos reported on earlier this year. This protocol was based, in part but by no means all, on the work of world-renowned autism researcher Simon Baron-Cohen. He’s the originator of the concept that autism is a result of an “extreme male brain” involving abnormal levels of testosterone during fetal development. Of course, the Geiers took the concept that elevated levels of testosterone might have something to do with autism and flew right into the woo-osphere with it, postulating that testosterone forms “testosterone sheets” that bind to mercury and that lowering testosterone levels in autistic children with powerful drugs like Lupron allows chelation therapy to work better. Never mind that on a stictly chemical level this entire idea is poppycock, with no support for it whatsoever.
Another area of science that the “biomeddlers” like to hijack wasn’t mentioned in the story. Specifically, it’s a variety of studies that suggest differences in glutathione metabolism and methylation in the brains of people with autism. Specifically, it’s been postulated but not well demonstrated that autistic children may make less glutathione. In a perfect case of crank magnetism, because glutathione is involved in mercury detoxification, anti-vaccinationists further postulate that low levels of glutathione in autistic children somehow make them more susceptible to “mercury” toxicity from the thimerosal in vaccines. Sounds nice, neat, and plausible, right? Wrong. For one thing, what was shown was that autistic children may have 33% less of the reduced form of glutathione and nothing about overall glutathione levels being different. It’s based on a flawed understanding of physiology and, like the very idea that the tiny amount of mercury that used to be in vaccines is sufficient to cause neurologic changes consistent with autism, implausible when you look at it more carefully, as Not Mercury described nearly four years ago:
If the average human carries around approximately 6 milligrams of mercury how much glutathione should we require to deal with environmental mercury levels ? Even if several molecules of glutathione were required for each mercury molecule, we should have millions of times sufficient glutathione to get the job done. Compare that to the reported upper limit of exposure through vaccines which has been estimated at less than 250 micrograms. A person so severely deficient in glutathione they would be unable to detoxify 250 micrograms of mercury probably wouldn’t survive long enough to be vaccinated in the first place. Every breath of air would expose them to lethal levels of ozone, pollutants and other oxidants.
Yet that doesn’t stop the “biomeddlers” from prescribing all sorts of “anti-oxidant” and “detoxification” cocktails containing glutathione and or its amino acid precursors, cysteine and glycine, to autistic children to “treat” their nonexistent thimerosal toxicity and/or “heavy metal” toxicity. Basically, once the anti-vaccine movement gets a hold of science, their application of it is related to the original research by coincidence only. Well, coincidence twisted by their over-arching belief that autism is due to vaccines and and “toxins.” This results in subjecting autistic children to pain for no gain:
- We tried Oral Glutathione; it resulted in a tremendous yeast outbreak. We also found studies that glutathione supplementation did not survive the digestive process to yield results.
- We tried Topical Glutathione; it caused a bad rash and undesired behaviors (this is an understatement!). At the time, there was only a soy-based topical glutathione – today you can acquire crème without soy or other allergens.
- We tried an initial dose of IV Glutathione: 250 mg (really an IV Push; 5-10 minutes)
a. Some hints: We brought a portable DVD Player along, and prepared his arm with a big glob of EMLA cream prior to infusions. At the time, Jeff was 5 years old and around 40 lbs. The first treatment was in Fall 2002.- Another type of glutathione administration is through a nebulizer.
None of this means that they can’t produce a whole bunch of science-y appearing studies in seeming support of their ideas, as both Kent Heckenlively and Terri Arranga tried to do in response to the Trib story, to hilariously misguided effect. Many of them can even draw convincing looking charts showing glutathione metabolism and make all sorts of hand-waving, science-y proclamations about how autistic children are have higher “oxidative stress.” It all sounds very, very plausible to people who are not biochemists. Again, however, it’s extrapolating preliminary data straight into woo land. As has been documented here and elsewhere time and time again, these studies virtually always fall into one of three categories. Either their findings are not related to the treatment claims made by the biomed movement (or only tangentially related), or, alternatively, they are so far in the realm of basic science that, even if the results pan out, they are years, if not decades, from potential clinical use, if they ever demonstrate clinical applicability at all. Finally, the third category of studies cited by the biomed movement are studies done by its members. These are virtually all of very poor quality, often lacking proper controls, or of inadequate power to tell us much of anything. Sometimes, like homeopathy studies, they appear to be “positive” studies of highly implausible hypotheses due to random chance. Worse, there is an intense hypocrisy in these studies. Investigators with massive conflicts of interest, like Andrew Wakefield, can have their “studies” funded by lawyers looking to sue vaccine manufacturers and the biomed movement sees nothing wrong with that. Yet this same movement dismisses any study in which even a single investigator has ever been funded by a pharmaceutical company, sometimes going to truly ridiculous extremes to do so.
In this, the autism “biomed” movement is very much of a piece with crank and pseudoscience movements of all kinds, be they creationists, believers in “alternative” medicine, 9/11 Truthers, moon hoaxers, Holocaust deniers, or believers in the paranormal. The ideas, even the fields, are different, but flaws in reasoning and science are the same. Studies are hijacked to have scientific implications far beyond what is justified by any reasonable scientific inference. Evidence itself is abused and twisted to appear to support a predestined conclusion, while the mountains of evidence that either do not support that conclusion is either ignored or attacked as the product of a conspiracy theory or conflicts of interest. This attitude leads to “unsinkable rubber ducks,” as James Randi called them, among them irreproducible complexity, the idea that the fall of the Twin Towers was an inside job, and homeopathy.
And anti-vaccine autism quackery, more popularly known as “autism biomed.”
Because, like all pseudoscience movements, autism biomed is based on faith more than science, all these factors conspire to lead to attitudes like that of Jeff Bradstreet:
Bradstreet said he would try IVIG on every young child with autism if he could.
“Every kid with autism should have a trial of IVIG if money was not an option and IVIG was abundant,” Bradstreet said. “It makes sense to try and would be ideal to give every young child a chance at it.”
His practice offers a playroom “infusion suite” that includes a train set, a TV and toys. “IVIG is so easy for the kids once the IV is in,” Bradstreet wrote in an e-mail.
The treatment is “extremely safe,” Bradstreet said. “In 10 years we have had no significant side effects apart from short-term headaches or fevers in about 10 percent of the kids.”
Bradstreet said in an interview that he had extensively discussed the Pardo paper with a co-author, Dr. Diana Vargas, at a meeting.
Vargas tells another story.
“I do not recall a conversation with Dr. Bradstreet about the topic,” Vargas wrote in an e-mail. “I agree with Dr. Pardo and Dr. Zimmerman that our study did not suggest there being a use for IVIG in autism.”
There’s no scientific evidence that IVIG works to do anything in autism, but Bradstreet thinks that every autistic child should have a trial of it anyway, relying on anecdotes rather than clinical trials.
Now, as much as I lambaste the autism “biomeddlers,” as I sometimes call them, I realize that they are not stupid people. Some of them are actually pretty intelligent. The is that the think they understand the scientific method, but they do not. They also have a very different view of what constitutes adequate “prior plausibility” of a medical treatment to justify using it on patients. Those of us in real clinical research (yes, in reference to the anti-vaccine movement, I meant that exactly the way it sounds) understand that you can’t just try any wild idea that comes to mind on a real patient. The Belmont Report, Helsinki Accord, and the Common Rule, all designed to protect human subjects, together demand that clinical research have a large amount of preclinical data from animal, cell culture, and observational studies to justify doing clinical trials from an ethical standpoint. Absent that evidence, doing clinical trials of unproven remedies is unethical. Absent clinical trials evidence, treating patients with such unproven remedies is similarly unethical.
Although I can’t understand it from personal experience, I can understand how parents of autistic children, particularly severely autistic children, can become desperate and think that they can’t wait. I can even understand to some extent the attitude of Kim Stagliano, whom I’ve roundly criticized on multiple occasions for her support of quackery. The problem is that she and other such advocates of biomedical quackery construct a false dichotomy. To them, if scientific medicine can’t cure their children, then they feel justified in using unproven and highly implausible remedies. Some even become like Kent Heckenlively, seeking out pseudoscience after pseudoscience, quackery after quackery, until he is spending $15,000 to take his daughter to Costa Rica for “stem cell injections” straight into her cerebrospinal fluid by lumbar puncture. It’s hard to be told that their children can’t be “cured” and will never be normal. Even so, Kim Stagliano is profoundly mistaken in labeling an expose of autism quackery as the “mainstream media” telling parents of autistic children to “let your children burn.” It’s far more like warning those who have not yet fallen under the spell of various quacks about treatments that either have no basis in science, are highly implausible from a scientific standpoint, and/or result from what I call an extrapolation of existing science far beyond what the data will support. The vast majority of themare ineffective at best or harmful at worst. In this, the Chicago Tribune has done the most amazing public service for autistic children and their parents that I’ve seen since I started blogging, given the harm these “biomed” doctors do.
Although I do blame some of the more obtuse parents, such as J.B. Handley, Jenny McCarthy, and Kim Stagliano, for in the arrogance of their ignorance continuing to promote the scientifically discredited myth that vaccines cause autism and all the attendant pseudoscience that derives from it, I don’t blame most parents. It is the numerous quacks who promote the myth that autism is “vaccine injury” and use that myth to sell various nostrums who most benefit and are most to blame. Some of them may honestly think they are helping; others may be scammers; but all of them forget the very first rule of medicine: First, do no harm.
75 replies on “The anti-vaccine “biomed” movement: Hijacking legitimate scientific research”
Nice piece Orac, from what you write the modus operandi of the autism biomed crowd appears almost identical to that of the many stem cell scams now operating in countries where regulations are weak or not properly enforced, for example this little gem in Panama which tries to hijack just about every adult stem cell paper ever published in support of its very dubious claims:
http://www.cellmedicine.com/index.asp
Indeed in the case of Kent Heckenlively the two woos clearly met.
The biggest threat of all this is clearly to the patients and their families who stand to loose most, but these charlatans also tarnish the reputation of very exciting areas of science and the scientists working on them.
@ Paul Browne
Saw the website, I just love how colored water and petri dishes seem to equate beautiful science. I often joke at work that if we really wanted the non-scientific public to get interested, we’d put food coloring in the buffers and always have something on a stir plate.
Kind of like passionlessDrone in comments yesterday suggesting that the GFCF diet is justified in part because high levels of IgA antibodies to gluten and gliadin have been found in Rett Syndrome.
I’ve always wondered if the vast majority of the parents trying to find a cure know the risks of some of these claims:
Chetelation-Can stop the heart and from the Tribune article there is a study actually showing adverse effects from the therapy itself.
Hyperbaric Oxygen-There are two risks. One involves the fact there have been catastrophic failures of the chamber killing people. The other involves oxygen toxicity from inhaling too much oxyhgen.
Selenium-Mentioned multiple times on the Age of Autism comment section it is one of the few substances in my laboratory that actually has a skull and cross bones on it.
I have a colleague who does (legitimate) research on the properties of water. A friend of his from the same field was visiting once and mentioned that she did a search once and saw that her research was mentioned all over the web by a bunch of weird websites talking about stuff that did not follow from her work.
AKA the homeopaths.
Hijack legitimate science to make yourself look smart.
As long as it is considered a medication, and not a supplement, that will not happen. When they try to manipulate the FDA, they will find that it is not as easy as they have been claiming. The FDA’s requirements for real research, and their inability to provide anything that meets the FDA’s requirements, are the reason they need to go overseas to inflict these treatments on their children.
I honestly believe the risks are underplayed, if they’re even discussed, when these quacks present these treatments to parents.
I do not have a child with autism. But I cannot imagine a scenario in which I’d risk my child’s life to cure them of it.
Hi Joseph –
The fact that antibodies to gluten have been found in Rhett and idiopathic autism is evidence that something is going on that can’t currently be explained. These findings would be pretty blase if we didn’t have something else, lots of parents of children with autism reporting drastic changes in their childs gastro intestinal function, or behavior with the removal of gluten from their diet.
Why should we assume that this is a coincidence? On the basis of a single trial with 13 participants? Because the opioid theory didn’t work out? Because you can’t figure out how there might be a mechanism of action? This isn’t about a lack of curiosity, but instead, a selective skepticism, which is just like not being skeptical at all.
What’s so funny about your response is a complete lack of intellectual curiosity on a post about how people are butchering the scientific method; we have clinical evidence of something going on kids with autism and these common dietary proteins. It doesn’t have to be causing autism, and it doesn’t have to be every single kid with autism.
A trial of the GF/CF diet should be considered by any parent with a child with autism, especially one with concrurrent gastro intestinal problems. A trial is inexpensive, safe and can be done by doing some cooking at the house for a few weeks. If nothing is observed, it is very straightforward to go back to eating a standard diet; I know many parents who have done this and their children are no worse for it. The only problem with this is the ‘gateway treatment woo’ argument, a perfect illustration of an evidence free, fear based line of attack.
– pD
EM Tech “Saw the website, I just love how colored water and petri dishes seem to equate beautiful science. I often joke at work that if we really wanted the non-scientific public to get interested, we’d put food coloring in the buffers and always have something on a stir plate.”
LOL, while I was doing my we had news crews come into the lab a couple of times to interview a couple of my colleagues who were doing far sexier research than I was. On one occasion they did actually ask the PI to fill a few flasks with different coloured liquids because they would look good sitting on the bench behind him as he was intervioewed, and they had to get food colouring from the hospital shop as nothing in the lab was colourful enough (and they were not about to waste culture medium on it). On another occasion they put a camera in a -20 freezer to for a dramatic reconstruction of the moment another colleague reached in and picked up a key blood sample.
So next time you are wondering what that blue liquid in the background is…
**WOO ALERT**
Oxidative stress, huh?
Take this recent release:
http://www.sciencedaily.com/releases/2007/03/070305202936.htm
It says that there is a correlative link between consuming large amounts of food in a single meal and dying early. The premise is that it doesn’t really matter what kind of food it is, because the process of digestion causes oxidative stress. The less food you eat, in conjunction with a greater expression of the SIRT1-gene in skeletal muscle, leads to less oxidative stress. So here’s a woopothesis:
1) Autism appears to be either congenital or given to arise in early childhood.
2) “Autistic children have higher oxidative stress.”
3) Excess food with decreased cellular metabolism causes oxidative stress.
4) Maybe diet has something to do with it. Diets change.
5) Some autistic children “grow out of it” or overcome it. Maybe it’s because their diets change over time.
6) Autism was believed to be partly related to neurological over-development in early stages. Oxidative stress might be a cause or an indicator of hyper-neurological development.
Conclusion) People who have “children with autism” are feeding them too much. Try cutting back on the formula, to levels that would be equal to or lower than those obtained through natural breast-feeding.
I just pulled this out of my arse. To someone who doesn’t know one way or the other, just add some graphs and poof, new “theory”. The difference? Putting this hypothesis to the test is less expensive than medication (you save money giving them less formula), and it’s easy to do. Is it ethical? Not if it’s touted as a treatment or a cure for autism, because it has no validity. It would be ethical to feed children less food and formula, provided they still receive the necessary level of nutrition, if that’s a personal “life choice” of the parent. But it’s still woo.
they don’t really see the risks, they think that its a choice between doing nothing or doing something. It’s pretty easy to see why they choose the latter. It’s also impossible to expect a lay person to understand all the biochem needed to debunk these people. The government needs to be involved in shutting this stuff down.
@pD
From your post, it seems you did not read the link I provided for you yesterday. Here it is again: http://tinyurl.com/yfo8dr4
This sort of misuse also might make researchers (the real ones) inclined to avoid the topic. I mean, if I was a neuroscientist it might strike me to look in some other direction, or to at least not pursue some aspect of it, if it was possible it would end up misused by cranks or would cause threats to my research by those science abusers.
I’m sure that’s impossible to document, but strikes me as a reasonable additional outcome of crankery: making research unpleasant.
Hi Todd W –
I got caught up with the real world yesterday. My apologies. I did see your post. but didn’t have time to respond. Thank you.
If my son’s hospital records were part of this study, he would have been in the ‘no gastro problems’ group; he was never given a formal diagnosis, and his pediatrician was completely uninterested in our concerns over his constant, frequent bowel issues. Review studies are nice because they give us a lot of data to comb through electronically, but they also have the capacity for false negatives by missing non diagnosed, but none the less real, problems.
– pD
Hannah Poling had mito problem and fever caused by vaccine (or disease) could cause brain damage. Quacks seized on this to say autism caused by fever from vaccine. So using IVIG and causing fever in 10% of autistic children is good??
“The government needs to be involved in shutting this stuff down.”
Freedom of speech is one thing. But willfully misleading (dare I say lying) people should be against the law. Especially when it endangers our health (would it amount to manslaughter if you intentionally create health risks?). Yes, this applies to all the manufactured controversies which only function is to enrich those that are “just asking.”
“That time which we really improve, or which is improvable, is neither past, present, nor future.”
Walden.
Foer the sake of fairness and balance will Orac blog on this?
http://www.lawyersandsettlements.com/articles/13161/swine-flu-vaccine-allergy.html
D’oh!
How could I forget how the anti-vaccine movement hijacked research on mitochondrial disorders to be “proof” that vaccines can cause autism? Mea culpa, that’s a big one!
@passionlessDrone
” Review studies are nice because they give us a lot of data to comb through electronically, but they also have the capacity for false negatives by missing non diagnosed, but none the less real, problems.”
All studies have the capacity for false negatives and conversely false positives.
This is so on target. The most consistent difference I’ve noticed during my life between those who are experts in any subject and pretenders is that the experts know enough to be painstaking in their observations, conservative in the conclusions they draw, then painstaking once again in verifying their conclusions, while the pretenders seem to feel that leaping to unwarranted and unverified conclusions is some sort of mark of genius.
It reminds me of the Woody Allen joke back when “speed reading” was in vogue and Evelyn Wood was the leading purveyor of speed reading courses. Woody said:
I took an Evelyn Wood Wood course, and I’ve just finished reading War and Peace. It’s about Russia.
#21 – What, that some people are allergic to vaccine ingredients? That’s been known for a very long time, and the potential risks are on the packet inserts. I assume doctors make their allergic patients aware of the risks as well. (I have no allergies so I have no personal experience.) Allergies to specific vaccine ingredients has exactly nothing to do with autism.
Oops, that’s #18, not #21. Sorry Jud.
Why should he? It’s a complete non-story. Yes, there is the potential for side effects; that’s well known and repeatedly acknowledged on this blog. One particular batch had a statistical fluctuation in the number of people who reacted, so out of an abundance of caution the batch was recalled just in case it wasn’t just a fluctuation.
There’s really nothing more to say about it.
We saw this with the Suzunne Sommers crap. Suzie Thighmaster was complaining, “Normal doctors will do these treatments but won’t promise that they will cure you.” The implication, of course, is that the whacks in her book ARE “promising to cure” you.
So apparently the problem with regular medicine is that they are unwilling to lie to you, whereas the cranks will tell you everything you want to hear.
Watchin U:
Your article states that a single death in Canada may be due to an anaphylactic reaction to the swine flu vaccine. Using the numbers from a Canadian Press release of Nov 16, 09:
gives a death rate of 1 in 6.6 million.
The batch that was associated with a 5-fold incidence of severe allergic reactions (1/20 000 vs. 1/100 000) has been recalled.
There have been 250 deaths in Canada at last report. This give a death rate of 1/130,000.
I got the shot.
In my comment #26, the sentence should read:
There have been 250 deaths documented so far from Swine Flu in Canada at last report.
#11: That’s the Politician’s Fallacy, I think. “Something must be done. This is something. Therefore this must be done.”
Hey, it looks like Big Pharma forgot to cover up 6 cases of adverse events from H1N1 vaccine in Canada: http://tinyurl.com/yerw3no Somebody was slacking off over at GSK. Either that, or there really is no cover-up, only systematic analysis of the data to come up with a reasonable and proper response… You know, scientifically? You decide.
@Rene
Nice post!
Sort of like the baseless organized slander campaign against chiropractors as it relates to stroke and cervical manipulation? Exactly like autism/vaccines all this anti-chiropractic group has on their side against chiropractors are anecdotal stories and a few stray but clueless health care providers but absolutely no concrete scientific evidence. Even their biased “studies”, which typically amount to a collection of case studies (stories), are woefully incomplete and have gaping holes in them.
I’m glad we finally agree that compelling story telling, even when corraborated by some clueless health professionals, simply does not meet the threshold required to be called conclusive science…
“Freedom of speech is one thing. But willfully misleading (dare I say lying) people should be against the law. Especially when it endangers our health (would it amount to manslaughter if you intentionally create health risks?). Yes, this applies to all the manufactured controversies which only function is to enrich those that are “just asking.”
@DrWonderful
Baseless????? There are lots of studies about the risks of chiropractics. You actually have to THINK and EXPLAIN why they are baseless before you can actually say they are baseless.
Of course, if one was actually going to think and examine evidence, one would inevitably have to admit that chiropractic is based on completely false ideas, about as useful as Tylenol for simple back pain, and useless-to-deadly for anything else.
So naturally “Dr”Wonderful couldn’t possibly countenance that.
DrWonderful: just curious, but are you physically capable of discussing a topic other than chiropractic? Something like, oh, I don’t know — the anti-vaccine “biomed” movement hijacking legitimate scientific research, perhaps? Just a thought.
T. Bruce Neely:
I’m jealous; I still haven’t been able to, though I hear they will start doing adults here soon. I’m glad you ran those numbers. It’s a simple calculation, but very useful when the anti-vaxxers start going off about the vaccine being deadlier than the disease. Obviously, even accounting for not everybody getting vaccinated and not everybody getting sick, the disease is still deadlier.
That’s a little misleading. Those are probably 250 confirmed deaths, right? That doesn’t tell you the impact of the flu season, and we’re not even at the peak of the season.
The 36,000 deaths/year estimate of the CDC is way higher than it would be if they just counted death certificates with “flu” in them.
Sort of like the baseless organized slander campaign against chiropractors as it relates to stroke and cervical manipulation?
Excuse me, “Dr.” Wunnerful, but the last time you made that charge, more than one respondent cited articles that provided quite sufficient basis to question cervical manipulation. And your only response was to run away. Now you’re back, repeating the same disproven nonsense. Did you actually think we’d forget how easily and completely you were discredited already? Or are so deep in your world of make-believe that you simply can’t imagine unpleasant realities not going away when you wish it?
If you were a REAL doctor of anything, you’d conduct yourself accordingly, and not spew lies and baseless accusations that only make you look disengaged and unprofessional.
Ever-so-slightly off-topic: I wanted to pass on this post at The Lay Scientist: Studying Anti-Vaccination Activists on the World Wide Web.
Orac, I just have to say that you are far and away my favorite blogger. I read several, most every day, but this blog is the only one that makes me feel like I’ve learned something useful to my everyday life.
For a period of time I sat on the board of the Colorado Autism Society, before I discovered your writings, and I cannot tell you how often I would hear about these children being treated with chelation, stem cells and other treatments that I now recognize as being sheer quackery. My specialty is infectious disease and epidemiology, so I never felt particularly capable of defending science and science-based medicine to those people who I came into contact with who espoused these ridiculous treatment regimens.
I just wanted to leave you a comment telling you how much I personally appreciate your clear, lucid and excellently-written posts on these and other topics. I recommend your blog to every single person I talk with, and I can only hope that one day you will write the book on quackery.
Hell, it could just be a collection of your posts for a week. 😛
Thank you again, truly.
Damien
“Dr.” Wunnerful is becoming the new H*ppeh
I daresay, you are guilty of using legitimate research way past the scope of the study conclusions to perpetuate your beliefs in the same manner that is the subject of this blogpost. All of your links were clinical studies and when the CMI profiles of autistic children with food allergies were compared with NT children with dietary protein intolerances, they were quite similar. You are trying to use these as epidemiological findings so let’s see what such findings suggest: http://leftbrainrightbrain.co.uk/?p=2652 Of course the original studies are linked. In short, there doesn’t appear to be any differences in the prevalence of GI disorders in autistic children compared to NT controls and that the GI complaints may be of a neurobehavioural origin, rather than actual biochemical or genetic.
Rather than revisiting the subject of chiropractic-induced strokes through neck manipulation (and the issues ducked by Dr. Wonderful in the discussion following the latest Desiree Jennings posting), I have a couple of questions that make Dr. Wonderful’s hijack at least somewhat relevant to autism and its false prophets/therapists:
1) Dr. W., you appear to dismiss theories about a vaccine-autism link as “slander” (which seems to put you on the side of evidence-based medicine, even if your understanding of the word “slander” is deficient). What then is your reaction to the vaccine denialism and antivax preachings that infest the chiropractic profession (anywhere from a third to half of chiropractors in various surveys admit to antivax views, and major chiropractic organizations think it’s acceptable for their members to denigrate immunization)?
2) Do you personally support vaccination, or are you merely using the example of antivaxery among some autism advocates as a springboard to attack those who “slander” chiropractic?
(and out of curiousity, what are your criteria for performing neck cracking and what form of informed consent (if any) do you seek from patients before performing this maneuver?
I recently met a woman whose 4-year-old daughter had just been diagnosed with Asperger Syndrome. The girl is extremely bright and verbal, even participated in a renowned university’s “gifted child” camp last summer. The mom was referred to me for info (I also have a child with AS) and I directed her to all my best sources, including Paul Offit’s book, Autism’s False Prophets. When I next talked with this woman I discovered she was, despite my best efforts, putting her daughter through the biomed ringer. Her explanation: “I read Paul Offit’s book and I read some biomed books, and the biomed books just spoke to me more.” So that says it all, really. It’s not about what’s true, it about what grabs them in the way they want to be grabbed. It’s infuriating.
I don’t understand why the authorities allow this. Parents subject their children to years of dangerous experimentation, and no one takes action? Chemically castrating your children is legal?
Excellent post as always.
I now have a new favorite word: woo-osphere. An instant classic.
The woo never ends. Just yesterday, another parent claimed on a local autism yahoo group I belong to that Generation Rescue and the NVIC were both good sources for medical information on vaccines and not “anti-vaccine” organizations. We have a LONG way to go. Thanks for helping us fight the good fight.
@ LW #43: This is why people are now starting to fight for “autistic rights.” If a “normal” child was being chemically castrated because his parents thought it would make him more compliant and agreeable, social services would be kicking the door down. But due to the hysteria around the supposed “epidemic,” everybody has been convinced that autism is the absolute worst thing on earth, a death sentence for the whole family. So autistic kids are being treated as less than human. Lab rats. They’re no good as they are, so why not do anything and everything possible to make them more normal? Can’t possibly make them any worse, right? That seems to be the reasoning.
Dangerous Bacon- Yes, I do feel vaccines are generally safe and have no overarching concern about this countrie’s vaccination policy. Most chiropractors actually feel the way I do although you will see some who are outwardly and vocally opposed. They make us cringe because it is not even in a chiro’s scope so lets net get too worked up. You know?
My criteria for cervical manipulation falls in line with the standard of care for all providers who perform spinal manipualtive therapy. This would include chiropractors, MD’s, PT’s and DO’s. My practice is limited to musculoskeletal conditions by choice. I feel it is important to note that even subluxation based chiropractors are essentially treating a musculoskeletal lesion. Indications are typically pain, inflammation, muscle spasm, asymmetrical movement, inability to perform normal daily fucntions, etc. The criteria is no different reall for cervical spine vs elbow vs low back vs. knee etc. Standard phy med. About 50% of my practice is extremities.
Treatment is typically coupled with passive and/or active modalities when indicated. Very, very, very rarely is manipulation the only procedure performed although it is the only one peple like you ever talk about. Sometimes nutritional or ergonomic counselling is indicated. Most DC’s have an ephasis on soft tissue work such as ART, Graston, etc. A lot of DC’s use rehab or home programming to help patients reach goals. Treatment has a beginning and an end with specific goals.
This is the way most chiropractors treat but I see that you guys constantly single out the diminishing few who think they are doing more when correcting the musculoskeletal lesion. Who cares what is it called, really? We think straight chiropractors who feel the subluxation is more than a musculoskeletal finding are now only about 10% of the profession and it goes down each decade. Where this came from is another topic and I always say “they might be right” but right now we don’t know that they are.
You might be suprised to the learn that chiropractic has outperfomed all other provider groups in the musculoskeletal world with regard to safety, cost effectiveness and clinical outcomes. A recent Mercer/Harvard study demonstrated this pretty clearly. All major health insurance carriers not only cover chiropractic services but many are now are beginning to emphasize it because the performance values they have determined with their own data.
We now have chiropractic physicians practicing in the US Capitol Health Services unit treating members of Congress and the President. We have chiropractors on staff at Bethesda Naval Hospital and Walter Reed Army Hospital. More than 30 VA hospitals now employ chiropractic physicians where an abundance of research is being conducted. Also, you may intersted in knowing that every major professional and Division 1 College sports team employ chiropractors. I am one of them. Currently, the Medical Director of the US Olympic program is Dr Reed, a chiropractic physician. several large orthopedic groups practces have begun replacing physiatrists and PT with soft tissue/rehab oriented chiro’s who also do use SMT. Chiropractic physicans have now begun teaching at some very prestigous medical schools such as Dartmouth, Brown and University of Rochester. Rumor has it Yale is currently looking to add a chirorpractic physician to the faculty as well. That means Harvard would likely follow soon after.
With regard to informed consent chiropractors are as obligated as any other health provider based on state standard of care as determined either by state statute or case law. The nature of that process varies from state to state. It is taught in chiropractic schools and we have a reputation of doing it at a high level of competency. When you discuss risks of alternatives it actually helps a patient choose chiro as an obviosuly safe option so we fully embrace it profession wide.
Informed consent as it pertains to stroke may vary because, to be quite honest with you, the evidence is actually not strong either way. It has been assumed for awhile, based on anecdotal story telling and biased testimonials from clueless , that a chiro can cause a stroke in a very rare instance but there is a growing body of evidence and case law that says it literally is impossible. As a result I tell patients just that (whichis what I am supposed to do)…I tell them there is quite a bit of confusion based on the hysteria created by a few with an axe to grind but the evidence is not clear evidence either way.
I use the same type of language that was endorsed by the Canadian gov’t after an exhaustive scientific inquest that pretty much says “present medical and scientific literature does not establish a definite cause and effect relationship between upper cervical manipulation and the occurance of stroke. However, I am letting you know that the controversy and possible association exists. In any case the questionable events are extraordinarily rare. If you experience…then…” Alternatives with their inherent risks and benefits are discussed therafter.
Anything else?
@Michelle #44
Through the determined efforts of two or three people, we have managed to eliminate most of the woo on my local autism support yahoo group. It’s taken a lot of effort, but simply by politely and consistently countering the woo when it first appears, I think we’ve done a pretty good job of educating the local parents. One has to remember that these local groups are not the same as the hard-core biomed groups, e.g. Autism-Mercury. The local groups have a mixture of parents – some with older kids, and some with newly diagnosed kids. Some actual adults with autism may be members. Keeping the parents of the newly diagnosed from falling into the trap of woo is a great goal, as these local groups are often their first exposure to the world of biomed.
I was very pleased when someone on my local group recently asked the question “Are you getting the H1N1 shot for your family?” and most people answered “yes”. When the question of mercury was raised, it was countered immediately (and not by me!) with the “less than in a tuna sandwich” factoid.
IMO, most parents want to know about the science. They want to feel well informed, and they don’t want to waste their time, efforts and money on things that have no chance of working. They want to hear success stories from parents of older children.
So, come on everybody, join your local group, and help counter the woo. Tell parents about how your child has progressed without quackery.
I am a high functioning autistic. This situation is truly bringing me to a rage. As horrible as it is to be autistic (imagine being unable to understand the entire rest of humanity until age 25), it is not a death sentence. It is not worse than a death sentence. Every autistic child who isn’t also afflicted with other problems is perfectly capable of enjoying his first 7 years of life even if he can’t speak.
Even if there might be something about mercury and autism, or vaccines, or autoimmune issues, or any other hypotheses, that only justifies the continued proper study of the disorder, not the placing of autistic children in what is essentially a cylinder of a diesel engine (in which one spark is enough to turn them into fuel).
Autistic kids of freaked out parents should be seized and fostered, just like diabetic kids of Jehova’s Witnesses.
@ Broken Link #47
The main support group in my area is run by the Autism Society of America, and they push the biomed really hard. Can’t tell you how many times I’ve sat in a meeting watching a new ASA member being indoctrinated. By the next meeting, that parent was already completely brainwashed (One of my favorites? A dad said, “My child isn’t on any medication.” When someone asked about this he said, “Well, just the biomed things, but no medication…”). I assume the Autism Society of America runs similar support groups all over the country. The ASA chapter in my area goes so far as to run a specific support group just for parents who do biomed or are interested in starting biomed. The Autism Society of America is a high profile org that draws in a lot of desperate-for-information parents of newly diagnosed children. So I blame them for the spread of a lot of this nonsense, at least in my neck of the woods.
Since Doc Wonderful is chomping at the bit for a response…
First off, congratulations for apparently having a relatively sane and evidence-based view of vaccination. Would that more of your peers felt this way, since vaccine-bashing is commonplace among chiropractors, out of ignorance and/or a compelling need to attack mainstream medicine.
“My practice is limited to musculoskeletal conditions by choice.”
Another reason for congratulations. See how well we’re getting along?
“…I see that you guys constantly single out the diminishing few who think they are doing more when correcting the musculoskeletal lesion.”
The theory of imaginary subluxations does get its share of jeers, but most critiques of chiropractic among physicians relate to chiros who feel that their “scope” includes adjusting babies for “birth canal injuries”, attempting to treat internal medical conditions and embracing various sorts of quackery from bogus nutritional therapies to giving treatment on Rube Goldbergesque machines whose chief utility is generating money for chiropractors.
“You might be suprised to the learn that chiropractic has outperfomed all other provider groups in the musculoskeletal world with regard to safety, cost effectiveness and clinical outcomes.”
Yes, I would. The evidence indicates that chiros don’t help patients more than other practitioners (including physicians and physical therapists) for musculoskeletal pain, including things like acute back strains (see the commentary here by Sam Homola, D.C.) As to cost-effectiveness, I wonder about that given the chiropractic practice model which has patients constantly returning to the office for “maintenance”. Safety is questionable given the high frequency of chiropractic side effects (generally minor in the area of things like pain and dizziness, but occasionally severe, and in the case of neck cracking, potentially disabling or fatal).
“My criteria for cervical manipulation falls in line with the standard of care for all providers who perform spinal manipualtive therapy.”
A RAND study (see the above link) showed that cervical manipulation was justified in only about one of ten cases where it was performed. Since chiros do roughly 90% of the spinal manipulations and have the philosophy that manipulation is the way to go in the vast majority of cases, it would appear that your profession’s “standard of care” leaves something to be desired.
“Informed consent as it pertains to stroke may vary..I tell (patients) there is quite a bit of confusion based on the hysteria created by a few with an axe to grind but the evidence is not clear evidence either way.”
So, you do not represent the danger accurately. Whether you sufficiently counsel patients as to the alternatives to neck cracking is difficult to judge. I suggest you read more of Dr. Homola’s articles on Science-Based Medicine, particularly his comments as to the exceedingly limited role for cervical manipulation and its attendant hazards.
Who made Dr Homola the King? He’s a hack. You may want to branch out a little and stop cherry picking from morons who write stuff you want to read. He aligns himself with that other creature of the night, Barrett. No one will ever take you seriously if you refer to these guys as your source of balanced information. What tingles my spine is that you likely are Homola himself because NO ONE ever references him other that he himself! He and you are both loooosssseeerrrrrrrsssss!!!
LAB: Your friend wants to feel like she’s doing something to help her child, as opposed to helplessly waiting to see if she’ll grow out of it. The biomeddlers tell her that she doesn’t have to accept that her child can’t be medicated or purified out of autism, so she goes for them.
Dangerous Bacon: I am still astonished that the neck-cracker callously blew off the testimony of KSC — and her offers to show him the MRIs and CTs done in March of this year on her brother, a once-healthy man who suffered severe damage at the hands of a chiropractor who cracked his neack.
Phoenix Woman,
You’ve undoubtedly hit the nail on the head with regards to those who turn to the woo for their children. I wrote on this earlier today, as I was writing a post on the IOM’s 2004 Immunization Safety Review: Vaccines and Autism and why the autism-is-caused-by-vaccines crowd is too lazy to read it.
Part of what I wrote, I’ll copy here, because I think it’s relevant. Some parents faced with autism or other disabilities choose to deal with things adaptively. Others turn to the anger and the woo. The comments at AoA show that the combination of the two can be intoxicating and lead to a self-righteous belief in their superior positions. It can also lead to martyrdom (wrote on that, as well, in another piece today, taking on the Stagliano burning house post).
I wrote:
What is a parent who just wants some answers to do? Who are you supposed to trust? It sucks to hear news you don’t want to hear. It sucks to be told that the causes of autism are not all known, to hear that there are no cures for what seems like a life sentence to a parent newly going through that diagnosis. And I know from personal experience that it really bites to be told when your wee one is five years old that he isn’t going to achieve independence and that the best he can hope for is a group home. It sucks even bigger to then spend 15 years working for thousands of hours with that child to try to change that prognosis and not be able to. It does.
I am so grateful that Bobby’s autism was diagnosed before the internet was really out there, before all these wackaloon theories were devised, before Wakefield. Before secretin. Before all this wooquack, DAN doctors, HBOT, IVIG, chelation and Yasko or PK protocols were out there. Before there were charlatans promising me a cure if I just drained my pocketbook over to them. It meant that over the last three-four years as my daughters’ autism became unavoidably apparent that I didn’t go to the woo. I’d already had a decade and half with my son to know that nothing would replace hard work and that even then, no miracles, no instant cures, were out there.
…
I understand wanting a child who is going to fulfill all of the things loving parents want for their children. I know firsthand the pain of watching your child’s peers pass them by. I have felt the heartache as each milestone is missed, as the years slip by and the progress does not come. I know and fully understand the pain involved with being the parent of an adult child whose disabilities preclude him from achieving independence and all of the adult milestones we wish for our children. I know the fear a parent feels regarding their child’s future. Who will be there to care for my child when I can no longer do so? And I feel that fear for all three of my children as all three are on the spectrum, and no matter how smart, how “high functioning,” independence is not a guarantee, not something a parent can just assume will happen.
Now, you have a choice as a parent to a special needs child, to special needs children: you can deal with it adaptively and allow yourself and your children to make good, productive happy lives despite the limitations or you can rage, rail, and be miserable and make your child miserable. Really.
You can be a victim, make your child a victim, act like a martyr and be miserable, making those around you miserable. Or you can choose differently. You can choose to find the beauty that is there in every moment, even the literally shitty ones. You can make the best and teach your child(ren) that obstacles and hurdles are things to be overcome, that perseverance and grace are things that can be found even when you are unbearably weary of the road you are on. You can teach them that shit happens, but it doesn’t have to ruin their lives. It doesn’t have to stop them from reaching their potential or you your potential.
KWombles, you rock. And you put it all in perspective. Jenny McCarthy and her ilk, they talk a good game about being “mother warriors” but they’re really still talking about the magic wand that’s going to make it all better…
Dr. Carlos Pardo complains that his research was hijacked by the woo[meisters. What did he do about it? Not much. I cannot find a letter to the editor of a major journal, etc. where he takes the woo-meisters to task. So, they just peddle their woo.
Researchers whose work is hijacked have an obligation to shout loud and long about how their work is being misused. Staying quiet is the same thing as approval.
Antaeus Feldspar:
I agree. I am also glad that I was dealing with my son before the internet. I did see some of the loony tune stuff when we did get internet about the time my son was almost in middle school.
Way to shred any last remnants of credibility you might have had, Dr. Wonderful.
a-non- Credibility here is not what I am hunting for…
KWombles…exquisitely written!
As an aside, my children(both autistic and non) and I finally got our H1N1 vaccines. Yay us!
Dangerous Bacon: Once again, I am still astonished that the neck-cracker callously blew off the testimony of KSC — and her offers to show him the MRIs and CTs done in March of this year on her brother, a once-healthy man who suffered severe damage at the hands of a chiropractor who cracked his neck.
Instead, he’s typing drivel like this:
Stunning. Just stunning.
P Woman- You’ve lost. Get over it. Anyone who cites Homola is a loser. Total loser. Complete unadulerated totally biased and easily defeated loser. Loser. Loser. Loser. Everything Homola has ever published has been completely dismissed by chiropractors and unaffiliated alike. Dangerous Bacon knows this very well. Possibly all too well. Don’t ya bubba?
Can you provide specific claims, Dr. Wonderful, to your assertion that Homola’s assertions are baseless and worthy of complete dismissal?
Dr. Wonderful:
I’m convinced! It was that fifth “loser” that did it.
**yawn**
So Mr wonderful (or is it Ms, either way I’ll take a bullet before I call a chiroquack “Dr”)you realise you have no credibility, you have no desire for credibility, but you continue to post bollocks. There is no option left but to call out as a troll.
Regarding Jeff Bradstreets comment about IVIG for autism:
Very odd. “Extremely safe”??
If a vaccine gave a 10% reaction rate of headaches and fever, this would be deemed by the antivaxers as hard evidence of unacceptable toxicity.
Here is an example of the hijacking, not of published science, but a mere hypothesis.
http://www.medicalnewstoday.com/articles/171457.php
This half-baked idea, which is apparently so science-y that it is unsuitable to be discussed in a press release*, has led to autism biomedders/antivaxers blaming vaccines and their miniscule gelatin content (which contains some glycine).
How long before the biomedders come up with a “glycine homeostatic restorative therapy” to cure autism?
If any of them do, can I claim the intellectual rights to it?
dt, can you really call it “hijacking” the hypothesis when the originators of the hypothesis clearly meant it to be abused in that fashion? In their full press release they say that their work is based on that of Russell Blaylock, Martha Herbert and Andrew Wakefield. If someone tries to tell me that this “think tank” came into this thing without an agenda to blame autism on vaccines, I don’t believe it for a second.
I wouldn’t even be surprised if it turns out that they were funded by Generation Rescue or a similar baloney factory for the express purpose of generating anti-vaccine propaganda; that is nearly exactly how Andrew Wakefield’s “research” came to be done, after all.
The most interesting thing to me about the press release is how much it reads like Scientology materials. In real science, hypotheses are generated and then they are subjected to testing and only if they survive repeated attempts to prove them false are they accepted as true (tentatively.) In Scientology writings, though, and in this press release, vaguely described processes of thought lead immediately to conclusions that certain things “must be”, and these conclusions are therefore dubbed “facts” and thereafter treated as truths – not tentatively, either, but unquestionably. As S. I. Hayakawa observed in a fairly classic commentary on Dianetics, it reads not like science but like science fiction – however much the two may look alike to a science-ignorant reader.
Spending the afternoon getting caught up on recent lit. This is an example of one of many of a growing number of studies that show the benefit of cervical manipulation. But the likes of Homola and others, who simply have a pre-determined opinion and will cherry pick the lit to support it an then flash it to you all, would never use this in their “review” of the research. Instead they’ll pull out the same 3-4 bullshit studies that say “no proven benefit” and repeat them over and over again. This is why Homola is totally full of shit and is considered by chiropractors (and anyone who dares to be objective) is a total loser.
http://www.ncbi.nlm.nih.gov/pubmed/19837005?itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum&ordinalpos=10
And here i was thinking witch hunting was dead…Just substitute ‘witch’ for ‘quack’.
Ironiclly, the orthodox have killled far more than the ‘quacks:
‘A definitive review and close reading of medical peer-review journals, and government health statistics shows that American medicine frequently causes more harm than good. The number of people having in-hospital, adverse drug reactions (ADR) to prescribed medicine is 2.2 million.1 Dr. Richard Besser, of the CDC, in 1995, said the number of unnecessary antibiotics prescribed annually for viral infections was 20 million. Dr. Besser, in 2003, now refers to tens of millions of unnecessary antibiotics.2, 2a
The number of unnecessary medical and surgical procedures performed annually is 7.5 million.3 The number of people exposed to unnecessary hospitalization annually is 8.9 million.4 The total number of iatrogenic deaths shown in the following table is 783,936. It is evident that the American medical system is the leading cause of death and injury in the United States. The 2001 heart disease annual death rate is 699,697; the annual cancer death rate, 553,251.5
http://www.whale.to/a/null9.html
Thats why the people are turning to the ‘quacks’…andwhy the ‘quacks’ are being hunted doctors with al the resources theye can command
#42 LAB
Who “diagnosed” your friend’s daughter with Asperger and why do they feel like they need to treat it, the child sounds like she was perfectly normal. I am sure there are quacks out to diagnose asperger or autism in order to get patients, but also legitimate doctors that correctly diagnose the condition. If I were a pediatrician I would hesitate to offer such a diagnosis if it meant the parents would go running off to do these alternative treatments.
My son is a working adult now, but if the Asperger diagnosis was around when he was a child he would have been given that diagnosis. We struggled for years, knowing that there was a problem but did not know what it was. Consequently he was mainstreamed his entire life and graduated with a degree in Chemistry.
He still has issues with social interactions, but we treat it as just skills he needs to focus on more than the average person. For example, we stress that he needs to learn to differentiate the people he works with and learn their names. It’s a joke in our family that he would not recognize me if I cut my hair (he told me that in elementary school)
Is there any research into the possible genetic basis? I feel that the Asperger personality runs strongly in my family. Are Asperger and Autism really a spectrum of the same thing or different entities that appear similar?
Dr. Wonderful,
Did the study you cited specifically use cervical manipulation as a treatment modaility? It doesn’t specify that in the abstract.
a-non: Yes. In this particular study they use the term “spinal manipulative therapy” or SMT. Depending on the source and author, or even professional discipline, you will see this also described as “CMT” (chiropractic manipulative therapy), “chiropractic adjustment”, “grade 4 mobilization” (non-thrust), “grade 5 mobiliazation” (thrust into paraphysiologic space), “manual therapy” (more of a contemporary european terminology but not specific because it includes grade 1-5 mobilization and soft tissue procedures).
Yes, it is just semantics to most people. However, the problem is the people who bash chiropractic by saying the proven benefit is absent in the literature fail to disclose to you the nasty little, but very intentional, trick they play. They lead you into searching for the term “chiropractic” which is very rarely found unless it is intentionally used by the author to inappropriately to bash the profession.
The issue at hand is that “chiropractic” is a profession and not a specific procedure. Like I said the procedure of manipulation is commonly described as SMT, CMT, Grade 4 mobs, Grade 5 mobs, Manual Therapy and various others names that escape me at this moment. So when you search for “chiropractic” in a pre-determined effort to disprove it’s validity you will draw a blank or run into the planted studies that bash the profession. This is what Homola and his ilk do. They are a joke. They know the “proof” of efficacy, safety, and cost effectiveness is found when you use the appropriate nomenclature.
This is because chiropractors, orthopedists, physical therapists and osteopaths all use the same 5 levels of mobilization and procedural nomenclature. I find it very funny when some anti-chiro basher describes a PT procedure as “SMT” or “Grade 5 mobilization” and acts as if it is any different than chiropractic manipulation (we actually perfected the procedure 100 years ago). Eliminate the word chiropractic from your search and you will see much more benficial research authored by Chiro’s, PT’s, DO’s and MD’s.
We do not do “chiropractic” research. We research specific procedures and protocols.
You did not answer my question. Did the study specifically refer to the effiacy and safety of cervical manipulation in the reduction of headaches? If so, what specific modalities were used, and are they similar to the ones that are alleged to cause strokes?
I believe the first word in my response was the answer to your question. They used spinal manipulative therapy..aka manipulation. Yes these also are the same procedures that are alleged, based on anecdotes, to cause strokes although there is a growing body of evidence that it is actually impossible.